Module 4 Flashcards
Seven bones of the skull
2 frontal, 2 parietal, 2 temporal, 1 occipital
Frontal, nasal, zygomatic, ethmoid, lacrimal, sphenoid, and maxillary bones, movable mandible make up the __________
Bony structure of face
Facial muscles are innervated by what two cranial nerves
CN V and CN VII
What major artery passes anterior to ear, over the temporal muscles and onto forehead
Temporal artery
paired parotid, submandibular, and sublingual salivary glands produce _____________
Saliva
3 functions of saliva
- Moisten mouth
- Inhibit dental carries
- digestion of carbohydrates
__________ glands located anterior to the ear and above mandible
Parotid
______________ glands located medial to the mandible at the angle of the jaw
Submandibular
_________________ glands located anteriorly in the floor of the mouth
Sublingual
Horizontal mobility is greatest between cervical vertebrae ___ and ___ or ___ and ____ in adults
4 and 5 or 5 and 6
The posterior triangle landmark of the neck is formed by what muscles and bones
Trapezius, sternocleidomastoid muscles, and clavicle
The____________ is the uppermost ring of the tracheal cartilages
cricoid cartilage
Largest endocrine gland of the body
Thyroid
Responsible for production of thyroxine (T4) and triiodothyronine (T3)
Thyroid
The __________ lobe of the thyroid is is present in about 1/3 the population
Pyramidal
In infants, the 7 cranial bones are separated by:
Sagittarius, coronal, lambdoid sutures
The membranous spaces where the cranial bones meet and intersect
Anterior and posterior fontanelles
Ossification of the sutures begins after completion of brain growth, at about _______ years of age
6
Until what point in gestation is the mothers thyroid gland the source of thyroid hormone for fetus
Second trimester
Since the pregnant mothers thyroid is the primary source of thyroid hormone in first trimester, mother should increase intake of ___________
Iodine
T or F: Thyroid size increases in pregnancy in areas of iodine deficiency but not in those with sufficient iodine
True
shortening or excessive contraction of the sternocleidomastoid muscle
Torticollis
is defined as an expression or appearance of the face and features of the head and neck that, when considered together, is characteristic of a clinical condition or syndrome
Facies
spasmodic muscular contractions of the face, head, or neck
Tics
fungal infection of the scalp
Tinea capitis
opens into the mouth next to the maxillary second molar tooth
Parotid (Stensen’s) duct
opens in a small papilla at the sides of the frenulum
submandibular duct (Wharton duct)
With the index finger and thumb of one hand on each side of the trachea below the thyroid isthmus, a tugging sensation, synchronous with the pulse, is evidence of tracheal tug sign which can indicate:
Aortic aneurysm
T or F: The thyroid gland moves with swallowing
T
Which lobe of the thyroid is usually 25% larger
Right lobe is 25% > than left
is subcutaneous edema over the presenting part of the head at delivery
Caput succedaneum
In a newborn: is a subperiosteal collection of blood and is therefore bound by the suture lines. It is commonly found in the parietal region and, unlike caput, may not be immediately obvious at birth
Cephalhematoma
T or F: cephalhematoma crosses suture lines
False; it does not cross suture lines
In newborn: skull asymmetry or a particularly flattened spot on the back or one side of the head
Plagiocephaly
In an infant, a mass over the clavicle, changing size with crying or respiration, suggests
Cycstic hygroma
A third fontanel, _______________, is located between the anterior and posterior fontanels, may be an expected variant and is common in infants with Down syndrome.
the mastoid fontanel
The anterior fontanelle should close by ____________ months of age in an infant
12-15
A snapping sensation, similar to the feeling of pressing on a ping- pong ball, indicates ______________ that may be associated with prematurity, rickets, hydrocephalus, marasmus, syphilis, or thalassemia.
Craniotabes
Cranial bruits are common in children up to 5 years of age or in children with __________
Anemia
With aging, the thyroid becomes more ___________, feeling more nodular or irregular on palpation
Fibrotic
Pain in the head
Headaches
Tumor in any of the salivary glands, but most commonly in the parotid
Salivary gland tumor
Underactive thyroid
Hypothyroidism
Which is more common: hypothyroidism or hyperthyroidism
Hypothyroidism
thyroid gland produces insufficient amounts of thyroid hormone is the ________________ pathophysiology for hypothyroidism
A. Primary
B. Secondary
A
insufficient secretion of thyroid hormone due to inadequate secretion of either thyroid-stimulating hormone (TSH) from the pituitary gland or thyrotropin-releasing hormone (TRH) from the hypothalamus is the ________________ pathophysiology for hypothyroidism
A. Primary
B. Secondary
B
Overactive thyroid
Hyperthyroidism
Skin and tissue disorder usually due to severe prolonged hypothyroidism
Myxedema
Decrease in metabolic rate, resulting in accumulation of hyaluronic acid and chondroitin sulfate in the dermis
Myxedema
Deposition of glycosaminoglycan in all organ systems leading to mucinous edema of facial features
Myxedema
Overactive thyroid caused by autoimmune antibodies to thyroid-stimulating hormone receptor
Graves’ disease
Graves’ disease is more common in women in ________
30s and 40s
Underactive thyroid caused by autoimmune antibodies against thyroid gland
Hashimoto disease
Due to underactive thyroid caused by antibodies; Often causes hypothyroidism; More common in children and women between 30 and 50 years; Progresses slowly over a number of years
Hashimoto disease
Palpable cystic mass in the neck of a newborn/infant
Thyroglossal Duct Cyst
Congenital lesion formed by incomplete involution of branchial cleft
Brachial cleft cyst
Excessive contraction of the sternocleidomastoid muscle in a newborn/infant
Torticollis (Wry Neck)
Neural tube defect with protrusions of brain and membranes that cover it through openings in the skull
Encephalocele
A problem in the formation, flow, or absorption of cerebrospinal fluid (CSF) which now leads to an increase in the volume of the CSF
Hydrocephalus
Circumference of head is smaller than normal because the brain has not developed properly or has stopped growing
Microcephaly
Premature closure of one or more cranial sutures before brain growth complete
Craniosynostosis
A direct embryologic extension on the brain
The eye
Muscles attached to the eye
4 rectus
2 oblique
Which cranial nerve connects the eye to the brain
CN II
_______ of the eye contains fat, blood vessels, nerves, and supportive connective tissue
Orbit
What provides oils to the tear film in eyelid
Meibomian glands
Provides a skeleton for the eyelid
Tarsus
located in the temporal region of the superior eyelid and produces tears that moisten the eye
Lacrimal gland
The flow of tears:
Flow over cornea and drain via the canaliculi to the lacrimal sac/duct, then into nasal meatus
The 6 eye muscles are controlled by which cranial nerves
CNS III (oculomotor), IV (Trochlear), and VI (abducens)
the oculomotor nerve controls what part of the eye
Levator palpebrae superioris (elevated and retracts upper eyelid), and all extraocular muscles, except for superior oblique and lateral rectus
Trochlear cranial nerve controls which part of the eye muscles
Superior oblique
Which cranial nerve controls the lateral rectus muscle
Abducens nerve
Outer wall of the eye Consists of
Sclera and cornea
The middle layer of the eye is called
Uvea
The middle layer of the eye consists of
Choroid, ciliary body and iris
The inner layer of the eye that consist of nerve fibers is the
retina
the dense, avascular structure that appears anteriorly as the white of the eye. It physically supports the internal structure of the eye
Sclera
By dilating and contracting, this part of the eye controls the amount of light entering pupil to retina
Iris
Fluid that circulates between the lens and the cornea
Aqueous humor
Produces the aqueous humor and contains the muscles controlling accommodation
Ciliary body
is a pigmented, richly vascular layer that supplies oxygen to the outer layer of the retina
Choroid
biconvex, transparent structure located immediately behind the iris
Lens
What allows for the retina to focus on images of varying distance?
The elasticity of the lens and contraction/relaxation of the ciliary body changing thickness
Sensory network of the eye
Retina
Where are light impulses eventually interpreted in the brain
Cerebral cortex
The site of central vision
Macula, or fovea
Eyes develop during the first ___________ weeks of gestation, but vision which depends on the CNS takes longer
8
Typical newborn visual acuity
20/400
Adult visual acuity is achieved at what age
4 years old
Increased levels of _________ during pregnancy may cause tears to feel greasy and cause problems for contact wearers
Lysozyme
The major physiologic eye change that occurs with aging is a progressive weakening of accommodation (focusing power)
Presbyopia
Risk factors for cataract formation
- family history of cataracts
- steroid med use
- exposure to UV lights
- cigarette smoking
- diabetes mellitus
- aging
Acute infection of sebaceous glands of Zeis
Hardeola (also called stye)
chronic blockage of meibomian gland
Chalazion
What is the most common cause of isolated unilateral sixth nerve palsy
Micro-vascular disease
T or F: Retinoblastoma is an autosomal dominant disorder
T
In a pregnant patient, diplopia, scotomata, blurred vision, and amaurosis fagux symptoms are indicative of
PIH: pregnancy induced hypertension
Nocturnal eye pain in older adults if a sign of ___________ and a symptom of ____________
Subacute angle closure, glaucoma
Measurement of visual acuity/central vision tests which cranial nerve
CN II (optic)
Vision that cannot be corrected to 20/_____ is considered legal blindness
200
Monocular diplopia is a(n) ___________ problem while binocular diplopia is a(n) _______________ problem.
Optical; alignment
Handheld card used to screen “near vision”
Rosenbaum Pocket vision screener
If pt’s eyebrows are coarse or do not extend beyond the temporal canthus, the patient may have ___________
Hypothyroidism
Elevated plaque of cholesterol deposited in macrophages most commonly in the nasal portion of the upper or lower lid
Xanthelasma
Fasiculations or tremors of the eyelids is a sign of
Hyperthyroidism
When the lower lid is turned away from the eye, it is called _____________ and may result in excessive tearing
Ectropian
When the eye lid is turned inward toward the globe, a condition known as_______________
entropion
An acute suppurative inflammation of the follicle of an eyelash can cause an erythematous or yellow lump and is generally caused by a staphylococcal infection
hordeolum, or stye
Crusting along the eyelashes may represent________ which caused by bacterial infection, seborrhea, psoriasis, a manifestation of rosacea, or an allergic response
blepharitis
Condition where the closed eyelid does not cover the globe
Lagopthalmos
T or F: subconjunctival hemorrhages resolve with medications
F: they resolve spontaneously
is an abnormal growth of conjunctiva that extends over the cornea from the limbus
Pterygium
A pterygium is more common in people who have been
Heavily exposed to UV light
Which cranial nerve controls corneal sensitivity
CN V (trigeminal)
Name for eye condition where lipids deposited in the periphery of the cornea
Arcus senilis
An eye abnormality of pupillary constriction, usually less than 2 mm in diameter; can be caused by opioid abuse
Miosis
Eye abnormality of pupillary dilation, usually more than 6 mm in diameter. Can be caused by eye drops meds, lesions, hypoxia, oculomotor (CN III) damage, acute angle glaucoma, and stimulants (cocaine, amphetamines, abuse)
Mydriasis
Failure of the pupil to respond can be caused by destruction to which cranial nerve
CN III
Bilateral, miotic, irregularly shaped pupils that fail to constrict with light but retain constriction with convergence
Argyll Robertson pupil
Unequal size of pupils
Anisocoria
Constriction of the pupil accompanied by pain and reddened eye, especially adjacent to the iris
Iritis (anterior uveitis)
Pupil dilated and fixed; eye deviated laterally and downward; ptosis — is a sign of damage to which cranial nevre
Oculomotor nerve (CN III) damage
Affected pupil dilated and reacts slowly or fails to react to light
Adie pupil (tonic pupil)
T or F: mydriasis is often seen in pt in a come
True
appears as a dark, slate gray pigment just anterior to the insertion of the medial rectus muscle
Senile hyaline plaque
What conditions may cause the lacrimal glands to enlarge
Tumors, lymphoid infiltration, sarcoidosis disease, Sjogren syndrome
The oculomotor nerve is cranial nerve _____
III
The Trochlear nerve is cranial nerve ________
IV
The abducens is cranial nerve ________
VI
Lid lag may indicate
Thyroid eye disease
T or F: the optic disc is considered a blind spot
T
Ratio of size of eye arterioles to venules
3:5 or 2:3
Called the fovea centralis or macula lutea
Macula
_________ in the eye may represent microaneurysms
Dot hemorrhages
White area with soft, ill-defined peripheral margins usually continuous with the optic disc
Myelinated retinal nerve fibers
Loss of definition of optic disc margin initially occurs superiorly and inferiorly, then nasally and temporally central vessels are pushed forward, and veins are markedly dilated
Papilledema
Caused by increased intracranial pressure transmitted along the optic nerve. Initiallly, vision is not altered
Papilledema
Physiologic disc margins are raised with a lowered central area. Blood vessels may disappear over the edge of the physiologic disc and may be seen again deep within the disc
Glaucomatous optic nerve head cupping
Ill-defined, yellow areas caused by infarction of nerve layer of the retina
Cotton wool spot
A common cause of cotton wool spot in eye is
Vascular disease secondary to HTN or DM
Retinal changes associated with hypertension have historically been classified according to the ___________ system of four groups of increasing severity
Keith-Wagner-Barker (KWB)
false appearance of strabismus caused by a flattened nasal bridge or epicanthal fold
Pseudostrabismus
How to distinguish pseudostrabismus from strabismus
Use the corneal light reflex
Using a corneal light reflex to distinguish between pseudostrabismus and strabismus, an asymmetric light reflex may indicate
True strabismus
In an infant, enlarged corneas may be a sign of
Congenital glaucoma
A finding of the eye in a newborn/infant that is often associated with other congenital abnormalities
Coloboma, or keyhole pupil
White specks scattered in a linear pattern around the entire circumference of the iris, called brush field spots, strongly suggest
Down syndrome
What test would you use for visual acuity in children 3-5 years old
LEA, HOTV
What visual chart for literate, verbal, and English-speaking children ages 6 years and older
SNellen or Sloan
The anticipated visual acuity for children aged 36 to 47 months should be_____ or better,______ for children aged 48-59 mos, and______ or better for children 60 mos or older
20/50; 20/40; 20/30
In a pregnant patient, you should avoid cycloplegic and mydriatic agents d/t systemic absorption but if necessary, what may descrease systemic absorption
Use of nasolacrimal duct occlusion
Bulging of eye anteriorly out of orbit
Exopthalmos
Most common cause of exopthalmos
Grave’s disease
Inflammation of the superficial layers of the sclera anterior to the insertion of the rectus muscles
Episcleritis
Two types of episcleritis
Simple, nodular
Deposition of calcium in the superficial cornea
Band keratopathy
Eye condition that is most commonly in patients with chronic corneal disease; may occur in patients with hypercalcemia, hyperparathyroidism, and occasionally in individuals with trauma, renal failure sarcoidosis, or syphilis
Band Keratopathy (the deposit of calcium in cornea??)
Causes a disruption of the corneal epithelium and stroma
Corneal ulcer
Both eyes do not focus on an object simultaneously but can focus with either eye
Strabismus
Interruption of sympathetic nerve innervation to the eye
Horner syndrome
Results in triad of ipsilateral miosis, mild ptosis, and loss of
hemifacial sweating
Horner syndrome
Opacity in lens
Cataract
Dot hemorrhages or microaneurysms and the presence of hard and soft exudates
Diabetic retinopathy (Background or Nonproliferative)
Development of new vessels as result of anoxic stimulation
Diabetic Retinopathy (Proliferative)
Vessels grow out of the retina toward the vitreous humor; may occur in peripheral retina or on optic nerve itself
Diabetic Retinopathy (Proliferative
Creamy white appearance of retinal vessels that occurs with excessively high serum triglyceride levels (usually > 2000 mg/dL
Lipemia Retinalis
Autosomal recessive disorder in which the genetic defects cause cell death, predominantly in the rod photoreceptors
Retinitis Pigmentosa
Disease of the optic nerve wherein the nerve cells die, usually due to excessively high intraocular pressure
Glaucoma
Glaucoma may also be congenital as a result of improper development of the eye’s______________ system
aqueous outflow
Inflammation in the anterior vitreous, ciliary body, and the peripheral retina
Intermediate Uveitis
Inflammatory process involving both the choroid and the retina; Most common cause is laser therapy for diabetic retinopathy but may also be seen in histoplasmosis, cytomegalovirus, toxoplasmosis, or congenital rubella infections
Chorioretinitis (Chorioretinal Inflammation, also called Posterior Uveitis)
Defective vision or blindness
Visual field defecets
Embryonic malignant tumor arising from the retina
Retinoblastoma
Most common retinal tumor in children
Retinoblastoma
Disruption of normal progression of retinal vascular development in preterm infant
Retinopathy of Prematurity (ROP)
Who is at highest risk for Retinopathy of prematurity?
birth weight of ≤1500 g or gestational age of ≤30
weeks or less
Abnormal bleeding of the blood vessels in the retina, in an infant
Retinal hemorrhages in infancy
Results from acceleration-deceleration impact head injury in abusive head trauma (shaken baby syndrome)
Retinal Hemorrhages in Infancy
Macular degeneration, also called age-related macular degeneration (AMD or ARMD), is caused when part of the retina deteriorates
Macular degeneration
Leading cause of legal blindness in people older than 55 years in the United States
Macular degeneration
Two types of macular degeneration
Wet (atrophic) and dry (exudative or neovascular)
In the ear, what provides an acidic environment that inhibits the growth of microorganisms
Cerumen
The ______________ is an air-filled cavity in the temporal bone
Middle ear
contains the ossicles, three small, connected bones (malleus, incus, and stapes) that transmit sound from the tympanic membrane to the oval window of the inner ear
The middle ear
separates the external ear from the middle ear
Tympanic membrane
Is the tympanic membrane concave or convex
Concave, pulled in at the center by the malleus
The tympanic membrane is translucent which permits what two parts of the ear to be visualized
Middle ear cavity and malleus
The middle ear mucosa produces a small amount of mucus that is rapidly cleared by the ciliary action of the
Eustachian tube
a cartilaginous, fibrous, and bony passageway between the nasopharynx and the middle ear
Eustachian tube
The eustachian tube drains into the posterior aspect of the
inferior turbinate of the nose
How are the middle ear secretions cleared to equalize the middle ear pressure with atmospheric pressure
Muscles that open the Eustachian tube during swallowing, yawning, and sneezing
What is the purpose of the Eustachian tubes draining to equalize the middle ear pressure
Permits the tympanic membrane to vibrate freely with sound waves
Membranous, curved cavity inside a bony labyrinth consisting of the vestibule, semicircular canals, and cochlea
Inner ear
a coiled structure containing the organ of Corti, transmits sound impulses to the eighth cranial nerve
Cochlea
contain the end organs for vestibular function
Semicircular canals
Equilibrium receptors in the _________ and ___________ of the inner ear respond to changes in direction of movement and send signals to the cerebellum to maintain balance
semicircular canals; vestibule
Hearing is the interpretation of
Sound waves
Hair cells in the _________________ detect sound vibrations and send the information to the auditory division of the eighth cranial nerve
organ of Corti
T or F: sound cannot be transmitted by bone vibrations of the skull that pass to the inner ear
F: it can be transmitted by bone vibrations
Which bones form the nasal bridge
Frontal and maxillary
The nasal floor is made up of ___________ while the roof is formed by ____________
Hard/soft palates; frontal and sphenoid bones
Mucus contains ______________ and _________________ that serve as a defense against infection
Immunoglobulins; enzymes
Receptors for smell are located in the _________________ that lines about half of the nasal cavities
olfactory epithelium
The two anterior cavities of the internal nose
Vestibules
posterior openings leading to the nasopharynx
Choanae
houses the sensory endings of the olfactory nerve and lies on the roof of the nose
The cribriform plate
__________________ a convergence of small, fragile arteries and veins, is located on the anterior- inferior portion of the septum
The Kiesselbach plexus
The adenoids lie on the posterior wall of the ______________
nasopharynx
parallel, curved bony structures covered by vascular mucous membrane—form the lateral walls of the nose and protrude into the nasal cavity
Turbinates
Responsible for warming, humidifying, and filtering inspired air
Turbinates
are air-filled, paired extensions of the nasal cavities within the bones of the skull; lined with mucous membranes and cilia that move secretions along excretory pathways; their openings into the middle meatus of the nasal cavity are easily obstructed.
The paranasal sinuses
sinuses that lie along the lateral wall of the nasal cavity in the maxillary bone
Maxillary
The ____________ sinuses that develop during childhood are in the frontal bone superior to the nasal cavities
Frontal
The _____________ sinuses lie behind the frontal sinuses and near the superior portion of the nasal cavity
ethmoid
The _______________ sinuses are deep in the skull behind the ethmoid sinuses
sphenoid
The tongue is anchored to the back of the oral cavity by its base and to the floor of the mouth by the __________
Frenulum
5 basic taste sensations
Sour Sweet Salty Bitter Umami (savory)
Real name for taste receptors (taste buds)
Fungiform papillae
_____________ ducts are parotid gland outlets that open on the buccal mucosa opposite the second molar on each side of the upper jaw
Stensen
________________ ducts open on each side of the frenulum under the tongue
Wharton
Drain saliva from the submandibular and sublingual glands to the sublingual carunlce at the base of the tongue
Wharton ducts
Adults have _______ teeth
32
Development of the inner ear occurs which trimester of pregnancy
First
Growth of _______________ may occlude the eustachian tube and interfere with aeration of the middle ear, predisposing young children to developing middle ear effusions
lymphatic tissue, specifically the adenoids
How does infants external auditory canal differ from adults
It is shorter and has an up award curve
How does infants Eustachian tube differ from adults
It is wider, shorter, more horizontal, and less stiff than the adult’s
T or F: the ethmoid and maxillary sinuses are present at birth
True but they are very small
When do the sphenoid sinuses develope
About 5 years old
The frontal sinuses begin to develop at what age
7-8 years old
When do the 20 deciduous teeth generally erupt in an infant
6 mos to 24 months
Sensorineural hearing loss first occurs with _______-frequency sounds and then progresses to tones of ________ frequency
High; lower
Loss of ________-frequency sound hearing usually interferes with the understanding of speech and localization of sound
High
_______________ hearing loss may result from cerumen impaction and tympanosclerosis or otosclerosis caused by calcification of tissues in the middle ear
Conductive
In the ear, results from blunt trauma and necrosis of the underlying cartilage
Cauliflower ear
small, whitish uric acid crystals along the peripheral margins of the auricles—may indicate gout
Tophi
If pain is present when you pull on the lobe of the ear, it may indicate
External auditory canal inflammation
Tenderness or swelling in the mastoid area may indicate
Mastoiditis
is the procedure used to inspect the external auditory canal, tympanic membrane, and middle ear
Otoscopy
results from eustachian tube dysfunction, leading to the development of a transudate in the middle ear
Otitis media with effusion
the effusion of ear becomes infected with bacterial pathogens, and the child typically shows signs of inflammation (e.g., pain, fever, redness, and bulging of the tympanic membrane)
Acute otitis media
often referred to as swimmer’s ear, is an inflammation of the auditory canal; Water retained in the canal causes tissue maceration, desquamation, and microfissures that favor bacterial or fungal growth
Otitis externa
Evaluating hearing test which cranial nerve
CN VIII
The Weber test helps assess ____________ hearing loss
Unilateral
The ________ test helps distinguish whether the patient hears better by air or bone conduction
Rinne
_______-conducted sound should be heard twice as long as ________-conducted sound
Air; bone
bilateral watery discharge and associated sneezing and nasal congestion
Allergy
bloody discharge from the nose
Epistaxis
bilateral mucoid or purulent discharge from the nose
Rhinitis or upper respiratory infection
unilateral, purulent, thick, greenish, malodorous discharge of the nose may be indicative of
Foreign body presence
unilateral watery discharge occurring after head trauma from the nose
CSF leak
When inspecting the nasal cavity with a speculum, which turbinates are visible
Inferior and middle turbinates
rhinorrhea, hyperemia, and edema of the nasal mucosa may be indicative of
Recent cocaine use
may be indicated by asymmetric size of the posterior nasal cavities
A nasal septum deviation
Which cranial nerve controls the sense of smell
CN I
Dry, cracked lips
Cheilitis
Deep fissures at the corners of the mouth that may indicate infection, irritation, nutritional deficiencies (iron and B vitamins), or overclosure of the mouth, allowing saliva to macerate the tissue.
angular cheilitis
Round, oval, or irregular bluish-gray macules on the lips and buccal mucosa are associated with
Peutz-Jeghers Syndrome
Ask the patient to clench their teeth and smile to observe the occlusion of the teeth. This would observe which cranial nerve
CN VII, the facial nerve
________ ulcers on the buccal mucosa appear as white, round, or oval ulcerative lesions with a red halo
Aphthous
A red spot on the buccal mucosa at the opening of the Stensen duct is associated with
Parotitis (mumps)
A thickened white patch lesion that cannot be wiped away, a premalignant oral lesion most commonly seen in individuals smoking or chewing tobacco
Leukoplakia
a diffuse, filmy, grayish surface with white streaks, wrinkles, or milky alteration in the mouth
Leukoedema
a localized gingival enlargement or granuloma, is usually an inflammatory rather than neoplastic change
Epulis
Ask the patient to extend the tongue while you inspect for deviation, tremor, and limitation of movement. The procedure also tests which nerve
Hypoglossal nerve (CN XII)
The hard palate may have a bony protuberance at the midline, called ____________ , an expected variant present in 25% to 35% of the population, more commonly seen in women than men
torus palatinus
A bifid uvula is also associated with _______________________, a disorder in which aortic root dilation and aortic dissection May occur
Loeys-Dietz syndrome
Four clinical signs assessed include tonsil enlargement, tonsillar exudates, tender and enlarged anterior cervical nodes, and absence of cough
streptococcal pharyngitis
Elicitation of the gag reflex tests which cranial nerves
Glossopharyngeal (CN IX) and vagus nerves (CN X)
A saddle-shaped nose with a low bridge and broad base, a short, small nose, or a large nose in a neonate/infant may suggest a
chromosomal disorder or congenital anomaly
A smooth philtrum in a newborn/infant, is characteristic of
fetal alcohol syndrome
Copious secretions that accumulate in the newborn’s mouth that return after frequent suctioning may indicate
esophageal atresia
is associated with congenital anomalies such as congenital hypothyroidism
Macroglossia
T or F: If the child is or has been crying, dilation of blood vessels in the tympanic membrane can cause a pinkish-red appearance
T
compulsive, unconscious grinding of the teeth
Bruxism
sensorineural hearing loss with advancing age
presbycusis
Abnormal squamous epithelial tissue behind the tympanic membrane; As the epithelial tissue enlarges, it can perforate the tympanic membrane, erode the ossicles and temporal bone, and invade the inner ear structures
Cholesteatoma
Reduced transmission of sound to the middle ear; can be in auditory canal, tympanic membrane or in middle ear; Causes include cerumen impaction, otitis media with effusion, acute otitis media, otitis externa, foreign body, cholesteatoma, stiffening of the ossicles, and otosclerosis (bone deposition immobilizing the stapes)
Conductive hearing loss
Reduced transmission of sound in the inner ear (cochlea, associated structures, or cranial nerve VIII); Causes include damage to cranial nerve VIII, in utero infection (e.g., cytomegalovirus, toxoplasmosis), genetic hearing impairment, genetic syndromes, systemic disease, ototoxic medications, trauma, tumors, or prolonged exposure to loud occupational and recreational noise; older adults results from degenerative changes in the inner ear or vestibular nerve
Sensorineural hearing loss
An inner ear disorder characterized by episodes of hearing loss, vertigo, tinnitus, and ear fullness; Likely caused by genetic and environmental factors; may be caused by excess secretion of endolymph or failure of resorption in the subarachnoid space
Ménière Disease
The illusion of rotational movement by a patient, most often due to a disorder of the inner ear
Vertigo
otolith fragments gravitate into the semicircular canal, and nerve sensors in the canal cause vertigo with head movements.
Benign paroxysmal positional vertigo
A bacterial infection of one or more of the paranasal sinuses; Inflammation, allergies, or structural defect of the nose may block the sinus meatus and prevent the sinus cavity from draining, creating an environment for infection; overproduction of mucus may result from inflammation and increase susceptibility to infection.
Sinusitis
Infection of tonsils or posterior pharynx by microorganisms; Microorganisms causing infection often include group A beta-hemolytic streptococci, other streptococcal species, Neisseria gonorrhoeae, Mycoplasma pneumoniae
Acute bacterial pharyngitis
A deep infection in the space between the palatine tonsil capsule and pharyngeal muscles; Thought to develop as a complication of adenotonsillitis or from blockage of the Weber glands, the salivary glands in the space superior to the tonsil in the soft palate; Typically polymicrobial, most commonly including group A beta-hemolytic streptococci and fusobacterium species
Peritonsillar Abscess
A life-threatening deep neck space infection that may occlude the airway; occurs in the potential space extending from the base of the skull to the posterior mediastinum between the posterior pharyngeal wall and prevertebral fascia
Retropharyngeal abscess
occurs through spread of nasopharyngeal infection or direct inoculation from penetrating trauma; most often in pediatric pt after an upper respiratory tract infection with spread to lymph nodes in retropharyngeal space; highest incidence is among children < 5 years of age; more frequently in boys; Predisposing infections include pharyngitis, tonsillitis, sinusitis, and dental infection; typically polymicrobial with group A streptococci, Staphylococcus aureus, and respiratory anaerobes as common causative organisms
Retropharyngeal Abscess
A cancer involving the oral cavity or related structures
Oral cancer
Most often, squamous cell carcinoma that originates in the basal cell layer of the oral mucosa; may occur as a primary lesion, metastasis from a distant site to the jaw or related structure, or extension from a nearby structure (nasal cavity)
Oral cancer
Chronic infection of the gums, bones, and other tissues that surround and support the teeth; Often results from poor dental hygiene (calculus and hard plaque not removed below the gum line) leading to chronic inflammation and infection of the gingiva and periodontal tissue; underlying bone is reabsorbed and teeth loosen
Periodontal Disease (Periodontitis)
Most common craniofacial congenital malformation; Thought to be caused by interactions between genetic and environmental factors; also occurs in genetic syndromes, fetal exposure to teratogens and conditions present in the mother; Result of the lip or palate failing to fuse during embryonic development before the 12th week of gestation
Oropharyngeal Clefts (Cleft Lip, Cleft Palate, Cleft Lip and Palate)
When would you conduct a pinhole test?
Using snellen chart if vision less than 20/20
How do you examine clarity of the cornea?
Shine light on it
T or f: blood vessels should be visible in cornea
F they should not be present
Test eye movements using what?
6 cardinal fields of gaze
How do you test extraocular muscle balance of eye
Corneal light reflex, if imbalanced perform cover-uncover test
What helps differentiate between chronic hypertension and pregnancy - induced hypertension (pih)
Retinal examination
Dry mouth
Xerostomia
inflammation of the vestibular nerve after an acute viral upper respiratory infection
acute vestibular neuronitis
In the mouth, I completely formed blood vessels proliferate, forming lesions of various shades and size as blood extravasates in response to the malignant tumor of the epithelium
Kaposi sarcoma
